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Suspicious thyroid nodule — SCE Endocrinology MCQ

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ModerateThyroidSuspicious thyroid noduleSCE Endocrinology

A 52-year-old woman has a 1.8 cm thyroid nodule found after CT chest. She is euthyroid and has no cervical lymphadenopathy. Ultrasound shows a solid hypoechoic nodule with irregular margins and microcalcifications. What is the most appropriate next investigation?

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Correct answer: E — Ultrasound-guided fine-needle aspiration cytology

Ultrasound-guided fine-needle aspiration cytology is best because suspicious ultrasound features in an euthyroid thyroid nodule should be stratified with image-guided cytology. The alternatives are less appropriate because uptake scanning is for suppressed TSH; calcitonin is not a universal nodule test; waiting ignores suspicious features; surgery without cytology bypasses standard assessment. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG230; BTA thyroid nodule guidance